This page lists some of the action toward parity compliance undertaken by state regulatory agencies since 2008.
Are we missing any actions taken by state regulatory agencies? Let us know at info@paritytrack.org
Allows Licensed Clinical Psychologists (LCPs) and Licensed Clinical Social Workers (LCSWs) to bill for services he or she personally provides or that are provided under his or her supervision. Payment shall be made to LCPs for the following services: psychological and neuropsychological testing; diagnostic evaluation; and therapeutic services provided in the office, home or community setting. Payment shall be made to LCSWs for the following services: diagnostic evaluation; and therapeutic services provided in the office, home or community setting. Direct supervision is not required under ILL.ADMIN. CODE tit. 89, § 140.400.
The Illinois Department of Insurance launched a consumer education awareness campaign (pdf | Get Adobe® Reader®) in partnership with other state agencies and healthcare organizations to help Illinois families across the state navigate health insurance coverage for behavioral health disorders. The Department of Insurance developed a consumer toolkit (pdf | Get Adobe® Reader®) as part of this campaign. It also held five in-person trainings (pdf | Get Adobe® Reader®) on health insurance coverage for consumers and providers. The program included live presentations from state agencies involved in parity implementation and enforcement and a question and answer session.
The Department of Insurance issued a bulletin (pdf | Get Adobe® Reader®) detailing the instructions to become an Illinois Qualified Health Plan for the 2017 Plan Year. Under the instructions, the Department will confirm that all qualified health plans’ benefit design complies with the Federal Parity Law and applicable state laws.
The Illinois Department of Insurance issued a press release (pdf | Get Adobe® Reader®) encouraging individuals to contact the Office of Consumer Health Insurance if they need help navigating their mental health and substance use disorder coverage.
The Illinois Department of Insurance issued a fact sheet that provides information about mental health and substance use disorderinsurance coverage. The fact sheet outlines which plans are under purview of the Federal Parity Law and applicable state parity laws. The sheet defines:
The Illinois Department of Insurance released a FAQ (pdf | Get Adobe® Reader®) on mental health parity that provides consumers with information about how the Federal Parity Law and applicable state parity law impact their insurance plan. The FAQ defines serious mental illness, substance use disorder, quantitative treatment limitations , and non-quantitative treatment limitations. It also encourages individuals to contact the Department if they are interested in having a complaint reviewed or questions answered.
The Illinois Department of Insurance issued a fact sheet to provide consumers with information on insurance coverage for autism spectrum disorders under the Affordable Care Act (ACA)and Illinois Insurance Code. The fact sheet provides information on how the ACA impacts coverage despite pre-existing conditions, autism screening, lifetime limits and annual limits , and coverage under age 26. It also provides information on plans that must comply with and covered treatments under the Autism Mandate in Illinois State law.
The Department of Insurance issued a bulletin (pdf | Get Adobe® Reader®) detailing the instructions to become an Illinois Qualified Health Planfor the 2016 Plan Year. Under the instructions, the Department will confirm that all qualified health plans’ benefit design complies with the Federal Parity Law and applicable state laws.
The Illinois Department of Insurance updated their webpage on insurance coverage for autism to provide detailed information on the Affordable Care Act and Illinois Insurance Code. The page includes information on who is covered under the Federal Parity Law and applicable state law, benefit package treatments requirements, and treatment limitations.
The Illinois Department of Insurance released their 2014 annual report (pdf | Get Adobe® Reader®) which comprehensively details their work over the past year. The report includes three actions related to parity released in 2014:
The Illinois Department of Insurance issued a fact sheet (pdf | Get Adobe® Reader®) on provider networks. In the network adequacy standards, the Department includes timely access to a sufficient number of mental health in-network providers.
On November 25, 2014, an amended Section of the Illinois Administrative Code became effective. This section on minimum standards applies to HMOs. According to the amendment, minimum standards have to be medically necessary as determined by the primary care physician, and by the HMO’s Medical Director if the HMO requires Director approval. The relevant parity provisions state:
The Illinois Department of Insurance issued a bulletin (pdf | Get Adobe® Reader®) providing insurance companies guidance on the nondiscrimination provisions applicable to transgender persons under the Affordable Care Act , the Illinois Human Rights Act, and the Illinois parity act. The bulletin interprets that mental conditions under Illinois state law include gender dysphoria and gender identity disorder. This clarification extends the Illinois parity act to these disorders.
The Illinois Department of Insurance issued a bulletin (pdf | Get Adobe® Reader®) to plans reminding them that they must comply with the Federal Parity Law. It specified that any behavioral health coverage must be at parity with coverage for other medical care for any behavioral health service covered.
The 2014 Benchmark Plan Affordable Care Act Benchmark template requires plans meet the requirements of the state mental health parity act. These include benefits for serious mental illness, according to medical necessity and, as a minimum, 45 days of inpatient treatment, 60 days of care and an additional 20 outpatient visits for speech therapy for the treatment of pervasive developmental disorders (Note – these limits may not be in compliance with the Federal Parity Law if they are more restrictive than the comparable physical health standard)
A health insurance issuer that offers health insurance coverage in the individual or small group market shall ensure that the coverage includes an essential health benefits (EHB) package. EHB includes mental health and substance use disorder services, including behavioral health treatment.
The Illinois Department of Insurance submitted the 2014 annual report (pdf | Get Adobe® Reader®) to the Governor. In the section outlining the work completed by the Legal Division, the report summarizes the Bulletin that provided guidance to insurers on complying with the nondiscrimination provisions applicable to transgender persons found in the Affordable Care Act, the Illinois Human Rights Act, and the Illinois Parity Act. The report also summarizes another bulletin that provided guidance on the Federal Parity Law.
The Department of Insurance issued a bulletin (pdf | Get Adobe® Reader®) briefly explaining a non-exhaustive checklist insurers can follow to become a qualified health plan on the Illinois Health Insurance Marketplace. At the end of the month, the Department released a bulletin (pdf | Get Adobe® Reader®) with detailed guidelines for the qualified health plan application process. According to the guidelines, the Department of Insurance will confirm the benefit design complies with the Federal Parity Law.
The Department also issued Review Requirements Checklists (pdf | Get Adobe® Reader®) that are available on their website. The review requirements for group health maintenance organizations, catastrophic plans, individual HMO policies, individual and small group accident and health insurance explain these requirements in detail. These documents were updated on 03/2016. The requirements include –